The relationship between Interleukin-6 Gene Expression and Adipokines and in Women with Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a complex endocrine–metabolic disorder defined by clinical and/or biochemical hyperandrogenism and ovulatory dysfunction and accompanied by chronic low-grade inflammation and altered adipokine and cytokine profiles. This study assessed interleukin-6 (IL-6) gene expression and its relationship with adipokines (adiponectin, leptin, ghrelin and resistin) and reproductive hormones (FSH, LH and prolactin) in women with PCOS compared with healthy controls. A case–control study was conducted from September 2025 to May 2026 at Al-Zahraa Teaching Hospital, Wasit, Iraq, and included 247 women (127 with PCOS and 120 controls). Venous blood (5 mL) was collected from each participant for biochemical, hormonal and molecular analyses; hormones were measured on Cobas analysers, adipokines by ELISA and IL-6 expression by RT-qPCR. Most patients were aged 26–35 years (53.5%) and had a BMI of 25–30 kg/mZ (56.7%). FSH was significantly lower in PCOS patients than in controls (5.04 ± 0.49 vs 7.52 ± 0.61 IU/L, p < 0.001), whereas LH was higher (8.72 ± 0.91 vs 5.95 ± 0.37 IU/L, p < 0.001),

giving an increased LH/FSH ratio (1.73 vs 0.79); prolactin did not differ (7.85 ± 1.15 vs 7.29 ± 1.63 ng/mL, p = 0.12).

Adiponectin (4.73 ± 1.25 vs 9.17 ± 1.16 ng/mL) and ghrelin (217.41 ± 28.35 vs 649.82 ± 42.05 pg/mL) were

significantly decreased, while leptin (531.28 ± 39.51 vs 107.6 ± 13.82 pg/mL) and resistin (2.16 ± 0.34 vs 0.17 ± 0.08 ng/mL) were markedly increased in PCOS (all p < 0.001). IL-6 gene expression was significantly upregulated in PCOS (3.38-fold vs 1.70-fold in controls, p = 0.001). In ROC analysis leptin had the highest diagnostic accuracy (AUC = 0.94), followed by resistin (0.93), adiponectin (0.92), the LH/FSH ratio (0.91) and IL-6 (0.89), whereas prolactin performed poorly (AUC = 0.56). These findings illustrate the central role of inflammatory, metabolic and endocrine biomarkers in the pathophysiology and diagnosis of PCOS, with leptin, resistin and IL-6 showing the best diagnostic capacity.